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Health-related quality of life correlates of the treatment decision making process of newly diagnosed prostate cancer patients

HEALTH-RELATED QUALITY OF LIFE CORRELATES OF THE
TREATMENT DECISION MAKING PROCESS OF
NEWLY DIAGNOSED PROSTATE CANCER PATIENTS
by
Antoinette Stephanie Giedzinska-Simons
____________________________________________________________________
A Dissertation Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(PSYCHOLOGY)
August 2007
Copyright 2007 Antoinette Stephanie Giedzinska-Simons

Research indicates that post-treatment health-related quality of life (HRQL) of cancer patients may be enhanced when patients participate in their own treatment decision making (TDM) process. This conception is based on a short history of research that has operationalized and has measured patient TDM often without the guidance of an accepted theoretical framework. The current study set out to operationalize and to design measures of the patient TDM process based on informed decision making theory comprising three measurable aspects of treatment information communication, treatment choice deliberation, and treatment choice appraisal. Exploratory factor analyses demonstrated that these measures possess good factor structures and internal reliability. In this study, measures of the TDM process and HRQL of 57 prostate cancer patients were examined prior to primary treatment and HRQL was examined again at one-month post-treatment, in order to determine whether patient participation in the TDM process would predict improvement to HRQL. Residualized hierarchical regression analyses revealed that the three aspects of the patient TDM process predicted few changes in HRQL outcomes. Despite the lack of support for the benefits of patient participation in TDM, the prostate cancer patients in this study reported having ample treatment information, being very involved in their treatment decision making, being very satisfied with their treatment choices, and having positive expectations about treatment outcomes. The men also reported having good HRQL at both time points. Post-hoc exploratory correlational and moderational analyses indicated that in some instances TDM participation may be a function of patients' treatment modality, age, or their disease severity. Implications for further research are discussed.

HEALTH-RELATED QUALITY OF LIFE CORRELATES OF THE
TREATMENT DECISION MAKING PROCESS OF
NEWLY DIAGNOSED PROSTATE CANCER PATIENTS
by
Antoinette Stephanie Giedzinska-Simons
____________________________________________________________________
A Dissertation Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(PSYCHOLOGY)
August 2007
Copyright 2007 Antoinette Stephanie Giedzinska-Simons